POS0176 DRUG RETENTION OF BIOLOGICS OR JAKI IN RHEUMATOID ARTHRITIS PATIENTS WHO FAILED TREATMENT WITH JAKI: RESULTS FROM THE ANSWER COHORT
Authors: N. Yoshida, R. Watanabe, W. Yamamoto, K. Murakami, K. Murata, K. Hata, T. Takeuchi, Y. Etani, Y. Okita, Y. Son, H. Amuro, H. Yamada, Y. Ueda, R. Hara, Y. Ozaki, T. Ito, M. Hashimoto
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Few studies have addressed what is the optimal therapeutic option in patients with rheumatoid arthritis (RA) who failed treatment with JAK inhibitors (JAKi). <h3>Objectives</h3> The aim of this study was to evaluate the drug retention, efficacy, and safety of biologics or JAKi in patients who showed an inadequate response to JAKi in a multicenter longitudinal cohort. <h3>Methods</h3> Patients who showed an inadequate response to JAKi and then switched to TNF inhibitors [TNFi], IL-6 inhibitors [IL-6i], or other JAKi were enrolled in this study. The drug retention rates of the three treatment groups were estimated at 12 months using the Kaplan-Meier method and compared after adjusting for potential confounders using Cox proportional hazards models. Disease activities evaluated with Clinical Disease Activity Index (CDAI) were also compared at 1, 3, 6, and 12 months between the three groups using the Mann-Whitney U test or the Wilcoxon signed-rank test. The reasons for drug discontinuation were analyzed using Fisher's exact test. <h3>Results</h3> A total of 140 treatment courses (TCs) from 106 patients were included (TNFi: 36 TCs, IL-6i: 34 TCs, and JAKi: 70 TCs). Baseline characteristics showed no difference in sex, disease duration, number of previous biologics/JAKi use, and ACPA positivity between the three groups, but the concomitant PSL dose was significantly lower in the JAKi group than in other groups (P=0.049). After adjusting potential confounders, drug retention rates of the three treatment groups did not differ; however, when limited to patients who initiated subsequent biologics/JAKi within 100 days after the termination of prior treatment with JAKi, the TNFi group exhibited a superior drug retention rate compared to the JAKi group (P=0.048, Figure 1A-1C). Regarding disease activity, the baseline CDAI of the TNFi group was significantly higher than the other groups (P=0.01, Figure 1D, 1E); however, the TNFi group tended to show better improvement in disease activity than the other groups. The reasons for drug discontinuation were not different between the three groups. <h3>Conclusion</h3> TNFi may have a therapeutic advantage compared to other therapeutic options in patients who failed treatment with JAKi. <h3>Acknowledgements</h3> I have no acknowledgments to declare. <h3>Disclosure of Interests</h3> Naofumi Yoshida: None declared, Ryu Watanabe Speakers bureau: Asahi Kasei, Chugai, Eli Lilly, GSK, and Sanofi, Grant/research support from: AbbVie, Wataru Yamamoto: None declared, Kosaku Murakami: None declared, Koichi Murata Speakers bureau: AbbVie GK, Eisai Co., Ltd., Pfizer Inc., Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Pfizer Inc., Bristol-Myers Squibb, Daiichi Sankyo Co. Ltd., and Asahi Kasei Pharma Corp, Kenichiro Hata: None declared, Tohru Takeuchi Speakers bureau: Asahi Kasei Pharma, Mitsubishi Tanabe Pharma, Taisho Pharmaceutical, Chugai Pharmaceutical, Eisai, Boehringer Ingelheim, Abbie, AstraZeneca, Bristol-Myers, Consultant of: Mitsubishi Tanabe Pharma Corporation, Taisho Pharmaceutical, Chugai Pharmaceutical, Boehringer Ingelheim, AstraZeneca, Grant/research support from: Asahi Kasei Pharma, Mitsubishi Tanabe Pharma, Taisho Pharmaceutical, Chugai Pharmaceutical, Eisai, Novartis Pharma, GlaxoSmithKline, Pfizer, Boehringer Ingelheim, Yuki Etani: None declared, Yasutaka Okita Speakers bureau: Chugai Pharmaceutical, Pfizer, and Ono Pharmaceutical., Yonsu Son: None declared, Hideki Amuro: None declared, Hirotaka Yamada: None declared, Yo Ueda: None declared, Ryota Hara Shareholder of: AbbVie, Eisai, Yoshio Ozaki: None declared, Tomoki Ito Grant/research support from: Asahi Kasei Pharma, Motomu Hashimoto Speakers bureau: Eli Lilly Japan, Chugai Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Bristol-Myers, Eisai Co., Grant/research support from: AbbVie, Asahi Kasei Pharma, Astellas Pharma Inc., Bristol-Myers, Eisai Inc., Daiichi Sankyo Company, Limited, Eli Lilly Japan., Novartis Pharma.